Toyota plan aids U of I hospital efficiency
Methods to improve work flow and cut errors are said to save money and increase patient satisfaction.
ERIN JORDAN
REGISTER IOWA CITY BUREAU
April 21, 2006
Iowa City, Ia. — Patients at University Hospitals are spending less time in waiting rooms, thanks to efficiency practices tested in the automobile industry.
"I used to wait for a long, long time," said Antonia Ainslie, 61, who has breast cancer.
Ainslie and her husband, Kirk, have shaved at least an hour off the time they spend at University Hospitals for Antonia Ainslie's biweekly chemotherapy treatments. The change came about after an efficiency review that reduced nurses' per-patient walking by 90 percent, cut patients' waiting time and bettered overall satisfaction, said Ami Gaarde, assistant nurse manager for the suite. "You're actually spending more time with patients," she said.
Techniques for improving work flow and reducing errors have been used for years by companies such as Toyota and Motorola. They are now gaining momentum in the health care industry because they save money and increase patient satisfaction, said Sabi Singh, University Hospitals' director of operational improvement.
"I don't see a better need for this kind of process than in health care right now," said Singh, who came to the U of I last year from Michigan, where his company produced components for Ford, Chrysler, General Motors and Toyota.
University Hospitals is among at least a dozen Iowa hospitals using or considering using Lean Manufacturing, a zero-waste process developed by Toyota, the Iowa Business Council reported. The hospital decided to hire Singh, at an annual salary of $100,000, after researching how Lean techniques were working for other council members, said Ann Madden Rice, chief operating officer at University Hospitals.
"We took a risk that Lean would work in the health care environment," Madden Rice said.
The risk seems to be paying off. Patient satisfaction has risen by nearly 10 percent in the hospital's Emergency Department after a November efficiency review.
"In the ER, the goal was to improve the wait time," Singh said.
Singh and department leaders started by mapping out each step in an ER visit. They eliminated steps that didn't benefit the patient and standardized procedures so there are fewer opportunities for errors. Among its changes, the team limited the number of times a patient recounts his or her medical history, Singh said. Trauma rooms that would have been left open in the past are now being used for less-serious cases.
"We try to work through the entire process and see what the patient would want," said Eric Dickson, director of emergency medicine. "We really want to stand out as a department that has great services."
The goal of a recent review of the hospital's Digestive Diseases Department was to improve the three-month waiting period before colonoscopies and endoscopies, Singh said. It's too early to notice results, he said, but staff members have tightened scheduling and hired assistants to call patients in advance to make sure they are prepared for the procedures.
University Hospitals hopes the reviews will save money, but not, necessarily, in reduced staffing, Madden Rice said. "As improvements are made, staff time can be redirected to better quality and patient satisfaction, both of which reduce costs over time," she said.
